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To determine factors at hospitalization of cerebral venous thrombosis (CVT) which determine outcome at one year.
This was an ambispective study with outcome at one year follow up. Patients angiographically proven as CVT were included in study and functional modified Rankin Scale (mRS) determined at one year. They were dichotomized into “good” outcome (mRS 0-1) and “poor” outcome (mRS 2-6). Variables at admission were compared on univariate and then by cox proportional hazard regression for significance. Complications during follow up period were also compared.
One hundred and seventy five patients were included, data of 71 was collected prospectively. One hundred and seventeen (66.9%) had “good” outcome while 58 (33.1%) had “poor” outcome. Univariate analysis showed poor outcome associated with age<30 years, female sex, focal deficit, GCS≤12, ≥3 sinuses involved and intracerebral haemorrhage. On Cox proportional hazard regression only GCS≤12 was significant. Around 96% had complete/ partial recanalization at 6 months. Over one year, the complications included dural AV fistula in 10 (5.7%), intracranial hypertension in 4 (2.3%), venous thromboembolism in 6 (3.4%) and arterial infarct in 4 (2.3%). Proportions with complications in each group were similar. At one year 41 patients (25.2%) were continued on anticoagulation and 97 (55.2%) on antiepileptic drugs. Proportion in each group were similar.
In patients with CVT, GCS≤12 at admission was a predictor of poor functional outcome (mRS 2-6) at one year. During this period, complications were few and similar in the both the groups.
In patients with CVT, GCS ≤ 12 at admission was a predictor of poor functional outcome (mRS 2-6) at one year. PD173074 order During this period, complications were few and similar in the both the groups.
Cardioembolic stroke has a poor prognosis. We evaluated the region-dependent efficacy of endovascular therapy (EVT) based on diffusion-weighted imaging-Alberta Stroke Program Early CT Score (DWI-ASPECTS).
This post-hoc analysis of the RELAXED study, which investigated the optimal timing of rivaroxaban to prevent nonvalvular atrial fibrillation (NVAF) recurrence in patients with acute ischemic stroke (AIS), included NVAF patients admitted with AIS or transient ischemic attack in the middle cerebral artery (MCA), with internal carotid artery (ICA), M1, or M2-MCA occlusion. Relationships between DWI-ASPECTS region and functional outcome (modified Rankin Scale [mRS]), mortality, recurrence, and hemorrhagic stroke were compared between patients with and without EVT, and adjusted odds ratios for age, pre-stroke mRS, National Institutes of Health Stroke Scale (NIHSS), ICA occlusion, infarct size, recombinant tissue plasminogen activator (rt-PA) use, and onset-to-hospitalization time were estimated.
EVT patients had significantly lower hemoglobin levels, higher median NIHSS scores, more lentiform nucleus infarcts, ICA or M1-MCA occlusions, treatment with rt-PA, and fewer M3, M5, or M6 infarcts and M2-MCA occlusions than no-EVT patients. EVT patients had shorter onset-to-hospitalization times and more frequent favorable functional outcomes (p=0.007). Mortality, recurrent ischemic stroke, and hemorrhagic infarction were similar in both groups. EVT was associated with significantly better functional outcomes among patients with insular ribbon (p=0.043) and M3 (p=0.0008) infarcts. M3 patients had significantly fewer rt-PA and EVT, and longer onset-to-hospitalization times.
An occlusion in the insular ribbon or M3 region was associated with favorable functional outcomes in patients treated with EVT after cardioembolic stroke.
An occlusion in the insular ribbon or M3 region was associated with favorable functional outcomes in patients treated with EVT after cardioembolic stroke.
The purpose of this study was to investigate the risk factors associated with recurrence of posterior communicating artery aneurysms after treatment and to evaluate the significance of fetal-type posterior cerebral artery as an independent risk factor for recurrence of posterior communicating artery aneurysms.
The clinical and radiological findings of 220 posterior communicating artery aneurysms treated between January 2009 and December 2016 in a single tertiary institute were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the association between clinical and radiological variables and recurrence.
Of 220 posterior communicating artery aneurysms, 148 aneurysms were unruptured and 82 aneurysms were treated with surgery. Forty-six out of 220 aneurysms (20.9%) were associated with fetal-type posterior cerebral artery. Overall recurrence rate was 19% (42 out of 220 aneurysms) during mean 54.6±29.8 months follow-up. Multivariate logistic regression analysis showed th cerebral artery can be considered as an important risk factor for the recurrence of posterior communicating artery aneurysms, along with other known risk factors such as size, ruptured status, endovascular treatment, and incomplete occlusion.As rooftop solar photovoltaic (PV) adoption in Australia is exponentially growing in the past decade, there is a need to promote effective product stewardship for PV panels reaching their end-of-life (EoL). This paper presents the development of a System Dynamics (SD) model for managing EoL rooftop PV panels based on the circular economy concept. Four stages of the SD modelling process include problem scoping and variable identification, model conceptualisation, SD model development, and scenario analysis. Stakeholder engagement is central to this research as the system under study is underpinned by high uncertainties and limited data availability. Four socio-technical transition pathways examined in this study include market-driven growth, conservative development, shared responsibility, and disruptive change. The simulation results indicated an improvement of collection and recovery performance when a stringent product stewardship scheme is enabled and improvement of installers’ participation in the collection program. This study argued that a system of shared responsibility will be capable of balancing techno-economic motivations of stakeholders across the supply chain to participate in the recovery scheme, while being less disruptive to PV adoption. Under this scenario, a gradual change in regulatory requirements (e.g. recovery target and material recovery rate requirements) is introduced to allow a period of industry and market development.